We have several our former students who after building up successful Medical Massage practice, based on effective solving of somatic abnormalities, started to branch out into Medical Massage protocols for the visceral disorders. Curt Lezanic is one of them.

Curt’s personal journey in this direction started after he fully restored function of bladder in his older patient who was diagnosed with Hyperactive Urine Bladder. All available therapies used by urologist and neurologist failed and patient suggested to live with it as only solution.

However Curt was able to eliminate secondarily reflex zones formed in the soft tissues, according to Glezer/Dalicho zones for urinary system, and completely restored bladder function.

This clinical case is great illustration of Curt’s professional expertise and his abilities to examine, detect and methodically eliminate reflex zones in the soft tissues formed secondarily and body reaction to the pneumonia.

Dr. Ross Turchaninov, Editor in Chief


Subtitle: “I had no idea you could help with pneumonia”

By Curt Lezanic, CMMP, LMT
San Antonio, Texas

I am continuing to be amazed about what we as trained massage therapists can do to improve the medical condition of our patients. SOMI provides us with the knowledge, professional expertise and necessary support to bring real positive changes to the patients with a wide range of pathological conditions. The following clinical case is an excellent example of the clinical powers of Medical Massage in the case of residual stage pneumonia.

I had been working with a 74 year-old male patient for about a month. He had his knee replaced about three months prior to our first meeting. Initially he had almost no flexion of the knee and had significant edema of the knee, leg and foot. We quickly made progress with the edema and flexion. About this time, his wife had fallen and broke her arm. Her arm was placed in a sling and was secured to her body with a strap to minimize movements and prevent displacement of the fractured bones. She developed significant peripheral edema on her upper extremity and because all efforts to reduce it failed, she was referred to a lymphedema specialist. Fortunately for the patient she had to wait a month to see the specialist. Because of the wait time, her husband sent her to me.

I saw her several times and we quickly got the edema under control. At one point, there was about a two-week break between appointments which I started to use as supportive therapy. The day prior to the appointment, her husband called to cancel it. He informed me that she had developed sever pneumonia the prior week and was unable to come in for our appointment. He went on to say that he wished I could fix the pneumonia also. I told him that I couldn’t “fix” it, but that I most likely could provide her with some additional relief. He was amazed but believed me.

I told him that if he wanted me to help his wife I would need to know which lobe of which lung was harboring infection. I also said that I would need a couple of days to review the pneumonia protocol. He called me back almost a week later and told me that her pneumonia was better now and it was in the lower lobe of her right lung. I can only wonder what her doctor thought when he was asked about the clinical information given to a massage therapist. Anyway, we scheduled her first appointment.

When she arrived, I was prepared to do the entire Medical Massage protocol for pneumonia which I learned from Volume II of Medical Massage textbook. After examining the patient, it became apparent that generally speaking she was over her disease. However, she continued to suffer from very restricted breathing. To maintain normal oxygen level in the blood she was forced to breathe very quickly and it completely exhausted her. Her pulmonologist suggested breathing therapy with a respiratory technician, but it didn’t help a bit while additionally exhausted her and she stopped it after two sessions.

I decided that rather than doing the full pneumonia protocol, I would simply use the Glezer/Dalicho Chart for Pulmonary Disorders to work on her tissues according to recommendations of Dr. Glezer and Dr. Dalicho to restore elasticity and mobility of the soft tissues throughout her chest, coordinate function of respiratory muscles and eliminate restricted breathing.


While examining her chest’s soft tissues layer by layer I detected the presence of the reflex zones and matched my finding with the Glezer/Dalicho chart. Fig. 1 illustrates Glezer/Dalicho zones for the pulmonary disorders.

Fig. 1. Glezer/Dalicho zones for the pulmonary disorders

The chart gave me the entire picture of soft tissue abnormalities which formed secondarily in soft tissues of her chest due to the severe pneumonia.

I found that reflex zones in the skin (i.e., cutaneous reflex zones) were located over the right scapula and on the right anterior shoulder. These areas presented as thin black, horizonal lines on the chart.

Testing for the tension in the superficial fascia revealed that connective tissue zones of the second level were located in the upper back between both scapulae. In the chart Connective Tissue Zones indicated as green dotted areas.

Tension in the skeletal muscles in the form of active trigger points was located in intercostal muscles between 8 and 12 ribs on the right and in upper and lower parts of both trapezius muscles. These areas presented as thick black, double lines on the chart.

I didn’t find any periostal reflex zones since her pneumonia didn’t get into the chronic state and reflex zones in the periosteum didn’t have time to form yet.


I began my treatment with the cutaneous reflex zones. I rolled and stretched the skin in all areas that I previously identified as problematic and later on used superficial frictions. When I finished, I asked the patient to take a deep breath. She complied and immediately reported that it was easier for her to breathe.

Next, I used Connective Tissue Massage in the areas of fascial tension. At the end I again asked the patient to take a deep breath. The patient once more reported that her breathing became even easier.

Finally, I removed all active trigger points in the trapezius and reduced tension in the intercostal muscles using various chest techniques. One more deep breathing test and my patient reported that her breathing had returned to normal! She was totally amazed at the results of only one session of Medical Massage. Her pulmonologist was greatly impressed by her sudden progress.

From a personal perspective I, like my patients, are continually amazed at the power of Medical Massage. Learning, embracing and utilizing these concepts has allowed me to realize that we as massage therapists are in a unique position.

In many clinical situations we are the only real option for patients whether it’s helping a patient breathe easier, restoring normal range of motion or restoring normal balance between the sympathetic and parasympathetic divisions of the autonomic nervous system.

I pray that more and more therapists embrace Medical Massage and SOMI’s training for the sake of the patients and our entire profession!


1. The highest level of professional expertise for a massage therapist who practices any application of clinical massage is his or her ability to actively participate in treatment of visceral disorders using reflex mechanisms of Medical Massage Therapy.
2. Every visceral abnormality carries the somatic component which has a different level of clinical expressivity. These pathological somatic changes are called reflex zones and they formed secondarily as a body’s reflex reaction to the visceral abnormality.
3. Another equally important mechanism is restoration of balance between sympathetic and parasympathetic divisions of the autonomic nervous system using soft tissue manipulations and through correct activation of the peripheral receptors.
4. Medical Massage is an important supplementary tool to help patients with visceral abnormalities, but it is much more critical for the patients with pulmonary disorders because respiratory muscles are the engine of respiration and their normal function equals proper oxygenation of the blood. This case is a great illustration of the Medical Massage Concept for the treatment of patients with pulmonary disorders.

Science Of Massage Team

Category: Blog